POS1396-HPR DOES FIBROMYALGIA WORSEN CATASTROPHIZING IN PATIENTS WITH RHEUMATOID ARTHRITIS?
Authors: H. Boussaa, O. Hamdi, S. Miladi, H. Ben Ayed, L. Souabni, K. Ouenniche, S. Kassab, S. Chekili, K. Ben Abdelghani, F. Alia, A. Laatar
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Pain is a cardinal symptom of several rheumatic conditions such as rheumatoid arthritis (RA) and fibromyalgia. Catastrophizing incorporates an amplification of symptoms associated with pain, and therefore contributes to its sustainability. <h3>Objectives</h3> We aimed to assess the impact of RA-associated fibromyalgia on catastrophizing. <h3>Methods</h3> We conducted a cross-sectional study including RA patients meeting the 2010 ACR/EULAR criteria. Patients were divided into two groups: group 1 (G1) including patients with fibromyalgia associated to RA, and group 2 (G2) including patients with RA. Fibromyalgia screening was based on the Fibromyalgia Rapid Screening Tool (FIRST). RA activity was assessed using the Disease Activity Score (DAS<sub>28</sub> ESR). Quality of life was assessed using the Health Assessment Questionnaire (HAQ). Catastrophizing was assessed using the Pain Catastrophizing Scale (PCS), which is composed of 13 items. The PCS total score varies between 0 (absence of catastrophizing) to 52 (significant tendency to catastrophizing). The cognitive and emotional representation of pain was assessed by the Brief Perception Illness Score (BPIS). It consists of 9 items: 8 quantitative questions on a numerical scale ranging from 0 to 10, and one last item in the form of a qualitative question. The total score varies from 0 to 90, without predefined thresholds. The higher the score, the more threatening the patient's perception of the disease is. The significance threshold was set at a p value of 0.05. <h3>Results</h3> Our study included 80 patients (G1: N= 40 and G2: N=40), 76 women and 4 men, with an average age of 59±9 years [42-77] in G1 and 53±10 years in G2 [37-74]. The mean disease duration was 11.29±6.24 years. RA was erosive in 90% of cases. Rheumatoid factor and/or ACPA were positive in 85% of cases. The mean delay between fibromyalgia and RA diagnosis was 49±7 months. Seventy five percent of patients were on corticosteroids with an average dose of 10 mg per day of Prednisone equivalent. All patients were receiving a DMARD: methotrexate 85%, leflunomide 11.2%, and biologics 37.5%. The mean VAS pain was 6.3±1.8 cm in G1, and 5±1.1 cm in G2. The mean VAS fatigue was 6±2.3 cm in G1, and 4 ±0.9 cm in G2. The mean global patient assessment was 5.9±2 in G1, and 3±0.5 in G2. The mean morning stiffness duration was 30 minutes in G1, and 55 minutes in G2. The mean DAS<sub>28</sub> ESR was 5±0.7 in G1, and 3.97±0.5 in G2. The mean HAQ was 1±0.3 in G1, and 0.7±0.1 in G2. Catastrophizing was greater in patients with RA-associated fibromyalgia with a mean PCS of 41± 8.2 in G1 vs 32±4.4 in G2 (p=0.01). Cognitive and emotional impact was also greater in G1 compared to G2: the mean BPIS was 71±9 in G1 vs 55±7.5 in G2 (p=0.05). <h3>Conclusion</h3> Our study showed that fibromyalgia aggravates catastrophizing and illness perception in patients with RA. It is important to remind the place of cognitive therapy in the management of these chronic conditions. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.